SynthesisClinical obesity2026

Weight-Lowering Drugs and Natural Female Fertility-A Systematic Review and Meta-Analysis.

Shaikha Jabor Alnaimi, Dana Muwafag Alsugeir, Li Wei, Kirsten Harvey, Ruth Brauer

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Clinical obesity, 2026. The graph read 1 number from its abstract, feeding 2 cells of the map, but none could be read as for or against, so it casts no vote. Not yet cited in PubMed.

1number the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

Read, but not usablea number the graph found but could not read as for or against

Pregnancy & neonatalcomparator not stated · obesity, gdmfeeds 2 cells of the map
RR 0.780.41 to 1.49p = 0.45
A meta-analysis of ovulation rates comparing orlistat and metformin showed no significant difference (RR = 0.78, 95% CI: 0.41-1.49; p = 0.45).

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

Anti-obesity drugs×pregnancy & neonatal

No readable resultOpen on the map →What to test next →

No other readable study in this cell yet. This paper is the evidence.

Belief with this paperNo claim has been compiled for this cell yet.

Metformin×pregnancy & neonatal

No readable resultOpen on the map →What to test next →

3 readable studies in this cell: 0 favour the treatment, 3 find no difference, 0 favour the comparator.

Belief with this paper
0.00contested · 0 families support, 1 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
1 · no effect
NCT02932475831 enrolled · 2017
OR 0.860.63 to 1.19

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

4 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

5 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

6 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

7 · Who and what money

Authors and funding

5 authors.

Shaikha Jabor AlnaimiResearch Department of Practice and Policy, School of Pharmacy, University College London, London, UK.ORCID https://orcid.org/0000-0003-4313-5098
Dana Muwafag AlsugeirDepartment of Pharmacy Practice, College of Pharmacy, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia.
Li WeiResearch Department of Practice and Policy, School of Pharmacy, University College London, London, UK.
Kirsten HarveyResearch Department of Pharmacology, School of Pharmacy, University College London, London, UK.
Ruth BrauerResearch Department of Practice and Policy, School of Pharmacy, University College London, London, UK.

Funding

No grant is acknowledged in the PubMed record.

8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

Overweight and obesity are global health concerns linked to impaired female fertility. Weight-lowering drugs are an alternative for achieving weight loss; however, their effect on natural female fertility is unclear. A systematic review and meta-analysis were conducted to summarise the literature on the effects of weight-lowering drugs on ovulation, conception, pregnancy and live birth rates. Inclusion criteria comprised interventional and observational studies involving women with overweight or obesity receiving weight-lowering drugs, compared with non-users, lifestyle modifications or other medications. MEDLINE, Embase, CINAHL, CENTRAL and ClinicalTrials.gov were searched, yielding 2731 records. After screening, seven clinical trials were included (n = 575), six of which were randomised. Sample sizes ranged from 40 to 120 women aged 25.9-29.7 years. Six trials evaluated orlistat, while one assessed semaglutide. In four trials, orlistat was associated with a higher ovulation rate than lifestyle modifications. A meta-analysis of ovulation rates comparing orlistat and metformin showed no significant difference (RR = 0.78, 95% CI: 0.41-1.49; p = 0.45). Two studies reported pregnancy rates: one found a higher rate with orlistat compared to lifestyle modifications (23.3% vs. 6.7%, p = 0.044), and another showed that adding semaglutide to metformin increased the pregnancy rate compared to metformin alone (35% vs. 15%, p < 0.05). Future studies should address current limitations and evaluate the effects of newer weight-lowering drugs on natural pregnancy and live birth rates in adequately powered studies.

Indexed as

Anti-Obesity AgentsFertilityInfertility, FemaleObesityOverweightAdultFemaleHumansMetforminOrlistatOvulationPregnancyPregnancy RateSemaglutideAnti-Obesity AgentsMetforminOrlistatSemaglutidefemale fertilitypregnancyweight‐lowering drugswomen's health

Identifiers

PMID42307450
PMCPMC13274556

What OpenQuestion holds

Texttitle and abstract
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.